A case of ileal obstruction caused by endometriosis of the appendix

Abstract

Endometriosis is a disease in which endometrial tissues grow at locations outside the uterus.
A 36-year-old woman was referred to our hospital because of abdominal pain and vomiting. Laboratory data showed an elevated carbohydrate antigen 125 (CA125). Abdominal X-ray and CT scan showed obstruction of the ileum and the thickened cecum. Placement of a long intestinal tube resulted in symptomatic remission but obstruction of the ileum did not improve. During surgery, we saw that the appendix had swollen and became hard, especially at the tip, and firmly adhered to the ileum causing complete obstruction of the ileum. Thus ileocecla resection was performed. Microscopic findings showed endometrial stroma and glands at the submucosal structure of the appendix, which was compatible with the diagnosis of appendical endometriosis. The postoperative course was uneventful except minor wound infection, and she was discharged from the hospital on the 20th postoperative day.
Cases of appendiceal endometriosis account for about 3% of all cases of intestinal endometriosis. This comparatively rare case is reported here, together with a review of the literature.